October 7, 2009

October 7: Health Care Reform News

By Kelley Luckstein

Lesson 3: Standardize Care To Reduce Mistakes

Computerizing Records And Practices Can Ensure That Doctors Are Following The Best Possible Strategy


When a widely respected group of obstetricians said it had found an easy way to prevent infants from dying, the advice went largely ignored by dubious doctors.


Intermountain Health Care, located in Utah and Idaho, was one of the few health care providers to heed the American College of Gynecologists and Obstetricians' suggestion not to induce births before 39 weeks. After putting the claim to the test, Intermountain analyzed its electronic records and proved the obstetricians were right, eventually instituting the new policy. According to hospital estimates, that's kept between 400 and 500 babies out of the ICU.


"It's our belief that most of the problems that happen in health care are not because the right thing isn't known, but because the right thing isn't done consistently," said Greg Poulsen, senior vice president of Intermountain.


Administrators at these hospitals preach "evidence-based medicine," where the best practices are analyzed, identified and then made the norm. Standardizing care, they say, can reduce mistakes that keep patients in the hospital longer than needed. "Last I heard, no pilot intentionally landed with the wheels up, but that used to happen all the time before they had checklists and automated routines," Poulsen said. "What we've discovered is the thing that was most likely to keep people alive was being very routine in care."


To that end, the current health care bills encourage health IT systems, and some would set up councils and committees to identify the most effective practices. All of the bills circulating in Congress instruct the Health and Human Services secretary to set up standards for electronic records systems that health plans would have to follow under the threat of a financial penalty or decreased funding…


However, evidence-based medicine can be implemented in an analogue world as well. The Mayo Clinic has doctors apply for a 90-day Quality Academy, where they study ways to increase efficiencies and reduce complaints. Douglas Wood, the chair of the Mayo's division of health care policy and research, said the academy has done wonders for increasing efficiencies in everything from procedures to patient wait times


National Journal by Jason Plautz, 10/6/09



Doctor says Baucus Bill goes too far

As a citizen of the great State of Minnesota, as a former Canadian, and having worked as a physician in Great Britain and at the Mayo Clinic, I request that you vote and speak in opposition to the Baucus Bill of proposed health care reform that is under active consideration today.


The Baucus proposal, as does H.R. 3200, will legislate extensive micromanagement of the health care delivery system by the federal government. The proposal will restructure the delivery of health care.


Post-Bulletin by Suzanna L. Velhuis, 10/7/09


Top stories


Senate Timetable Slips As Moderates Demand Waiting Period

The National Journal
Oct. 7, 2009

The Senate will not likely consider healthcare overhaul legislation next week as planned, according to Senate Majority Leader Reid's office, and moderate Democratic senators might have further delayed efforts to complete the bill.

Senators Ask Reid and Baucus for More Time to Weigh Health Care Bills
The New York Times
Oct. 6, 2009

A group of centrist Democratic senators, who could determine the fate of the major health care legislation, sent a letter Tuesday to the majority leader, Harry Reid, Democrat of Nevada, urging that the public be given at least 72 hours to review the legislation before debate begins on the Senate floor.

Separately, the Finance Committee Republicans on Tuesday also demanded that top officials from the Congressional Budget Office and the Joint Committee on Taxation be brought before the committee to answer any questions ahead of any changes or a final vote on the health care bill.

Baucus Not Worried About CBO Score
The Hill
Oct. 6, 2009

Senate Finance Committee Chairman Max Baucus (D-Mont.) expects his committee will approve healthcare legislation in the coming days, saying an independent cost estimate won't unhinge the bill's progress.

Obama Finds Support Outside Party and Washington for Healthcare Plan

The Los Angeles Times
Oct. 7, 2009


At the president's request, Republicans, including Gov. Arnold Schwarzenegger, and independents from beyond the Beltway offer qualified support for healthcare overhaul. Related: Reform Gets Conditional GOP Support, The Washington Post

State-Run Health Plans Garner Support
The Wall Street Journal
Oct. 7, 2009

Some influential centrist Democrats in the Senate are warming to a compromise that envisions health-insurance plans run by state governments.



Study: Rescue Rate, Not Complications, Singles Out Great Hospitals
Fierce HealthCare
Oct. 6, 2009


Until recently, much analysis of hospital performance has assumed that complication rates are an important element in analyzing which hospitals performed well and which ones didn't. Now, a new study suggests that this assumption may be flawed.


Wellness/Chronic Care


Cutting Health Costs: Discounts For The Healthy?


Oct. 7, 2009


Amid the national debate over health care, one thing everyone can agree on is that costs can't keep rising. Five years ago, one company implemented a plan that it says has kept its health care spending from increasing. NPR spoke with the executive of grocery chain Safeway Inc. about the company's wellness incentive program.


Patient Advocates Fear Bias In Wellness Incentives


Oct. 7, 2009


On Capitol Hill, lawmakers seem eager to encourage employers to create and expand programs that tie a portion of workers' health insurance premiums to their willingness to change unhealthy behaviors. But there's growing concern that some of those programs represent a new way to discriminate against those in less than perfect health.

State news


Is Congress Giving States Too Much Power on Health-Care Reform?

Oct. 7, 2009


The "real action" in health reform may well be in the states, which could have a surprising degree of autonomy in determining how they implement the federal legislation, and whether it delivers on the promise of curbing soaring costs and providing coverage for nearly 50 million uninsured.




Mafia, Violent Criminals Turn to Medicare Fraud

Oct. 7, 2009


Lured by easier money and shorter prison sentences, Mafia figures and other violent criminals are increasingly moving into Medicare fraud and spilling blood over what was once a white-collar crime.


Reform efforts


AP Poll: Health Care Overhaul Has a Pulse

AP/Washington Post
Oct. 7, 2009

The latest Associated Press-GfK poll has found that opposition to Obama's health care remake dropped dramatically in just a matter of weeks. Still, Americans remain divided over complex legislation that Democrats are advancing in Congress. Click here for full poll results.

House Dems: Don't Tax 'Cadillac' Plans
Oct. 7, 2009

More than half of the Democrats in the House have signed on to a letter denouncing a key element of the Senate Finance Committee’s health care legislation as labor unions draw a line in the sand on paying for reform.

4 Senators’ Concerns Reflect Health Care Challenge

The New York Times
Oct. 7, 2009


Taken together, the four senators (Rockefeller, Snowe, Lincoln and Wyden) represent the spectrum of concerns Democrats will face in trying to assemble the 60 votes they need to get a bill through the full Senate using regular procedure. Satisfying each of them, without alienating the others, is the challenge facing Democratic leaders.

An Individual Mandate With More Teeth But Less Bite
The Third Way
October 2009


David B. Kendall and Anne Kim have posted a memo offering four ideas to maintain robust coverage without dinging the middle class: Instead of assessing a penalty, eliminate or reduce tax breaks for people who don't buy insurance; allow young people to pay lower premiums; ease the minimum benefit requirement; and allow more people to buy catastrophic coverage.


Health Information Technology


High-Tech 'Scribes' Help Transfer Medical Records Into Electronic Form
USA Today
Oct. 7, 2009


Instead of pens, scribes at the University of Virginia Medical Center use laptops as they trail doctors from bed to bed, taking detailed notes that will form part of each patient's electronic medical record. Experts say the scribes' role illustrates hospitals' often bumpy transition from clipboards and closets of paper charts to digital records.




Should America Copy the Dutch?
The Washington Post

Oct. 6, 2009


The Dutch run a health-care system that looks like a very sophisticated version of the Baucus plan. If we're going to rebuild in their image, we might want to take a closer look at what they've learned over the years.


In Netherlands, Insurers Compete Over Quality of Care

PBS-The NewsHour
Oct. 6, 2009


In the first of a series on health care abroad, Ray Suarez looks at how the Netherlands achieved a massive health care overhaul four years ago.

Tags: health care reform, Health Policy, Health Policy

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